key: cord-0864062-465p423v
authors: Lopez, Ruth Palan
title: Comment on: Coronavirus 2019 in Geriatrics and Long‐Term Care: The ABCDs of COVID‐19
date: 2020-05-29
journal: J Am Geriatr Soc
DOI: 10.1111/jgs.16543
sha: c54056dcc38a07a319bef127e2489405ad2d5765
doc_id: 864062
cord_uid: 465p423v

See the Reply by https://doi.org/10.1111/jgs.16548.

I am especially concerned for those residents with advanced dementia, who likely will not benefit from hospital transfers. Simply obtaining a code status and writing do not resuscitate orders are not enough because it only addresses the care that is not going to be provided. Instead, proxy decision makers should be offered a meaningful alternative, which I call intensive individualized comfort care (IICC). 2 IICC is a mode of care in which the entire healthcare team works together to ensure that residents are comfortable and have the best quality of life for as long as possible. Figure 1 provides an example of how to talk with proxy decision makers about IICC.

COVID-19 is a natural disaster, a major catastrophe, and a world crisis. It has produced a race to contain the spread, an amassment of ventilators, and a surge in intensive care unit (ICU) beds. All are critically important. However, in our haste to contain, amass, and surge, let us not forget that we must also relieve, treat, comfort, and support. We must provide an alternative to invasive, ineffective treatments. We must educate staff, stockpile medications for symptom control, and provide training in counseling and symptom management protocols. IICC is not abandonment. It is not hastening death. It affirms life and is care patients and families want. It is as critical during this time of crisis as are masks and gowns, ventilators, and ICUs.

Coronavirus disease 2019 in geriatrics and long-term care: the ABCDs of COVID-19

Intensive individualized comfort care: making the case

Conflict of Interest: The author reports no competing interests.Author Contributions: The author had sole responsibility for the writing of this letter.Sponsor's Role: No funders had a role in writing the letter or the decision to submit for publication.